When a client wants to discontinue therapy

Friends. Partners. Colleagues. It’s tough when any relationship ends. But it can be especially tough when a therapeutic relationship ends. This is even more true if your client makes that decision on their own and you don’t know why they’re moving on. 

Whether you’ve had a client quit therapy suddenly or disappear without notice (aka ghosting), we’ve got some advice to help you navigate the situation — both from a legal and professional standpoint and from a personal and emotional one. 

What is client disengagement? 

Client disengagement is when a client withdraws from treatment, stops engaging as much during sessions or is more resistant, starts missing sessions here and there or regularly reschedules them, or potentially ends the therapeutic relationship altogether. 

A client might let you know they want to end their therapy sessions — sometimes abruptly, sometimes with notice — or, in some cases, they may ghost you.  

Ghosting is a common term in the dating world. It’s when someone ends all communication with a person they’re seeing, without giving them any notice or explanation.   

It can happen to mental health providers, too. You might have a client who stops attending sessions and responding to your emails or calls. Sometimes, you might not know why this has happened. 

Why do clients discontinue therapy? 

It can feel like it’s your fault when a client disengages or disappears, but it’s very often not. There are so many reasons someone may pull back from their therapist and terminate their sessions. 

Here are just a few of those reasons: 

• Financial constraints: Therapy can be expensive and not everyone has access to insurance coverage. A client may not want to end your services, but financial concerns mean they have to. This can be uncomfortable to admit, making discontinuing therapy abruptly the easier choice.
  
  
• Logistical difficulties: Maybe a client can’t get childcare to attend their sessions, they’re moving, became ill, or work got busy. Therapy may be something they don’t have time for or can’t access right now.
  
  
• Emotional overwhelm: You might be dealing with some heavy topics in your sessions like grief, addiction, childhood trauma, or mental health disorders. Clients may find working through these topics too overwhelming at this point in their healing journey. They may feel shame, stigma, or a fear of judgment and want to — or need to — avoid these topics by hitting pause on therapy for now.
  
  
• Lack of progress or meeting their goal: A client may not be seeing progress as quickly as they’d like or, on the flip side, they may feel they’ve met their therapy goal and be ready to move on, even if they haven’t mentioned this success to you.    
  
  
• At-risk situations: Addiction, abusive relationships, mental health crises. A high-risk client could be facing a serious challenge that’s stopping them from accessing therapy.
  
  
• Attachment or transference issues: A client may have a fear of intimacy or rejection, or an avoidant attachment style, and feel the need to pull away from a therapist-client relationship. They may be projecting problems from past relationships onto you and feel the need to end the relationship.
  
  
• Fear of conflict and confrontation, or not knowing how to end the relationship: A client might feel like you’re not the right therapist for them and want to look for a different care provider. But fear of conflict or being unsure of how to communicate this to you might make ghosting or terminating therapy abruptly the easier option for them. They may be protecting their own mental peace by leaving without having to have a difficult conversation. 

The list could go on, but you get the point. Clients may want to or need to discontinue your services and stop going to therapy altogether for many different reasons. 

What are the signs a client is about to discontinue therapy? 

You’re a therapist, not a mind reader. So you can’t always tell when a client is going to discontinue therapy. In cases like illness, a client may not even know themselves!

That said, there are a few warning signs to look out for, including: 

• Not opening up about deeper topics or avoiding topics  
• Becoming disengaged during sessions — short answers, closed-off body language, and decreased enthusiasm  
• Expressing signs of overwhelm — heightened stress, anxiety, or hopelessness and despairing language 
• Expressing frustration with the therapy process or lack of progress 
• Cancelling or not turning up to sessions, or starting to come more sporadically 
• Reluctance to schedule future sessions or use of vague and ambivalent commitment language 

Keeping an eye out for these signs can help you take steps to help your client as best you can. You can address it directly before it becomes an issue or offer your client a break from sessions and the chance to re-evaluate how things are going in a few weeks or months. 

On the personal side, spotting these warning signs can reduce the shock you might feel when a client relationship ends suddenly. 

What to do when a client wants to discontinue therapy  

Now you know why it can happen and the signs to look out for, let’s talk about what to do when a client wants to quit therapy, whether they let you know in advance or not.

1. Don’t blame yourself 

This one’s an important one. As we’ve listed above, there are so many reasons a client might need to end their therapy sessions with you. There’s a good chance it’s out of your control and has nothing to do with you personally. 

Even if it is you, that doesn’t mean it’s about your skills as a mental health professional. Clients may feel they need a different therapist to get the best mental health support for them, whether that’s one with a different background, age, race, or area of expertise. 

2. Reflect and get feedback (if necessary)

We’re all human, so, of course, there may be room for improvement in your therapy practice. 

Go over your notes and reflect on how you engaged with this client and what support and treatment you provided. Without blaming yourself, see if you can identify areas you could have offered alternative support or interventions. 

If needed, ask colleagues or supervisors for feedback. Clients moving on can be a great opportunity for professional development. 

3. Reach out to your client 

If a client hasn’t scheduled a new session in a while or has missed a session and rescheduled, gently reach out to check in on them. Gently is the key word here. Aim to be a friendly reminder of your therapeutic relationship, should they need it.   

You might find your client provides a reason for discontinuing therapy or schedules a session. If a client confirms they’re terminating your services, document this and follow necessary procedures. 

Keep safety considerations in mind whether you hear back or not. For example, you may need to contact emergency services for vulnerable or at-risk clients, if needed. 

We’ve got more advice on how to discontinue therapy with a client. 

4. Offer a final wrap-up session or close treatment 

Offer your client a final wrap-up session. If they take you up on it, a final session is great for closure on both sides and can facilitate the client’s healing. Sometimes, it can help them get beyond certain patterns of behavior and be an opportunity to continue sessions with a different strategy or contract in place. 

In the session, you can go over your client’s progress and offer them: 

• Resources you think might be helpful, like educational materials or worksheets  
• Information on how to access emergency support, if they need it  
• Details of a trusted colleague or peer they can reach out to if they want to restart therapy with another provider  

If you don’t hear back from a client after a set amount of time, send a termination letter. The amount of time you wait depends on your own clinical judgment, the type of therapy you provide, and individual cases. Reach out to a supervisor or colleagues for a second opinion if needed. 

In your termination email, you could offer the above resources and contact details and let your client know you’re closing their file, but will be available should they want to reach out for support in the future. 

Not sure what to say? Upheal is working on a termination letter template and discharge notes, which will hopefully help make the process a little easier.

5. Keep detailed notes 

Document the process — including times you reached out, any missed sessions, and the wrap-up session if it happened. Proper documentation is needed to protect yourself legally from abandonment claims. It can also be useful if a client comes back in the future to restart therapy with you. 

Consider using AI tools like Upeal to make detailed notes in less time. Upheal’s AI progress notes feature automatically creates notes from your sessions. You can focus on your clients, instead of taking notes, and every detail is captured for you to go over afterwards. 

Session analytics — like talking ratio and client sentiment on certain topics — can also help you spot signs of client disengagement early or go over areas you could improve professionally. 

6. Respect your client’s decision  

We know you know this, but it’s worth mentioning. Whatever happens, whether you hear back from your client or not, you’ve got to respect their decision to end their therapy journey with you. 

We only know a small part of what clients are going through. As nice as it would be on a personal level to get an explanation, make sure you respect a client's decision if you don’t hear back or don’t fully understand their reasons for quitting therapy. 

Plus, you never know, a client could come back in the future when they’re ready to restart care, and you can be there to help them.

All you can do now is wish them the best, wrap up your care with them as their therapist, and then focus on your other clients. 

Final thoughts 

To throw it back to where we started: endings are hard. When a client stops seeing you — either suddenly, without notice, or even when they’re upfront and let you know well in advance — it can be a tough pill to swallow. 

Use the end of a client relationship as a chance to reflect on and develop your therapy skills, offer appropriate closing care, and consider tools like Upheal for automated termination templates or discharge notes for added documentation support.